Objectively measured physical activity and depressive symptoms in adult outpatients diagnosed with major depression. Clinical perspectives (original) (raw)
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Journal of affective disorders, 2016
Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD). Investigate levels of PA and SB and their predictors in people with MDD. Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted. Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years; range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and e...
Journal of Experimental Psychopathology, 2022
Reduced physical activity is considered a key feature of major depressive disorder (MDD). However, research directly comparing non-depressed controls and patients yielded mixed findings. In contrast to most previous research, this study compared objective as well as subjective activity levels of individuals with MDD with non-depressed controls and used an ambulatory assessment method. Moreover, we investigated whether objective and subjective measures of activity could predict mood. On two consecutive days, physical activity of 35 MDD patients and 36 non-depressed control participants were assessed objectively using an accelerometer and subjectively with hourly ecological momentary assessments. During the same assessment, participants mood was monitored. No significant differences between MDD patients and control participants in objective and most of the subjective activity measures were observed. We found significant associations between objective and subjective measures of activity in non-depressed as well as in MDD patients. Objective but not subjective measures of activity predicted subsequent mood. Our results support the notion that the association between MDD and activity level is complex and depends on moderating factors.
PloS one, 2015
Exercise can relieve both depressive and anxiety disorders and it is therefore of importance to establish movement patterns of mildly to moderately affected sufferers to estimate the treatment potential. The aim is to describe the physical activity patterns of people affected by mild to moderate depressive and/or anxiety symptoms using objective measures of physical activity. The design of the study was cross-sectional using data from 165 people aged 18-65 years, with mild to moderate depressive and/or anxiety disorder symptoms (scoring ≥ 10 on the PHQ-9). Diagnoses were made using Mini International Neuropsychiatric Interview (MINI) and symptom severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). The participants wore accelerometers for a week to evaluate physical activity patterns. No statistically significant differences were detected between different diagnoses, though depressed participants tended to be less active and more sedentary. Only one-fifth...
Walk on the bright side: Physical activity and affect in major depressive disorder
Journal of Abnormal Psychology, 2012
Although prescribed exercise has been found to improve affect and reduce levels of depression, we do not know how self-initiated everyday physical activity influences levels of positive affect (PA) and negative affect (NA) in depressed persons. Fifty-three individuals diagnosed with Major Depressive Disorder (MDD) and 53 never-depressed controls participated in a seven-day experience sampling study. Participants were prompted randomly eight times per day and answered questions about their physical activity and affective state. Over the week, the two groups of participants did not differ in average level of physical activity. As expected, participants with MDD reported lower average PA and higher average NA than did never-depressed controls. Both participants with MDD and controls reported higher levels of PA at prompts after physical activity than at prompts after inactive periods; moreover, for both groups of participants, PA increased from a prompt after an inactive period to a subsequent prompt at which activity was reported. Depressed participants in particular showed a dose-response effect of physical activity on affect: longer duration and/or higher intensity of physical activity increased their PA significantly more than did short duration and/or lower intensity physical activity. Physical activity did not influence NA in either group. In contrast to previous treatment studies that examined the effects of prescribed structured exercise, this investigation showed that self-initiated physical activity influences PA. These findings also underscore the importance of distinguishing between PA and NA to gain a more comprehensive understanding of the effects of physical activity on affect in MDD.
Does physical activity protect against all-cause mortality in major depressive disorder?
Academia Mental Health and Well-Being, 2024
Background and Aims: It is not yet well understood whether physical activity may protect against elevated mortality in major depression. Answering this question has implications for policy and practice. The aim of this study was to estimate the association of physical activity (PA) with mortality in major depressive disorder. Methods: We used data from the Canadian Community Health Survey (CCHS) Mental Health and Wellbeing, conducted in 2001 (n=31,200) and the CCHS Mental Health Survey, conducted in 2012 (n=20,935) in this analysis. Recreational physical activity was measured using MET values, classifying participants as active, moderately active, and physically inactive in the 2001 survey and as very active, active, moderately active and physically inactive in the 2012 survey. Major depression was assessed using a fully structured diagnostic instrument, the Composite International Diagnostic Interview. Mortality data was obtained through data linkage. The analysis used Cox proportional hazard models to explore the associations. Results: Physical activity in the 2001 survey was protective: HR 0.69 (95%CI .64-.74), HR 0.77 (95%CI .72-.83) for active and moderately active groups, respectively. In the 2012 survey the HRs were 0.55 (95%CI .43-.70), 0.57 (95%CI .43-.75) and 0.59 (95%CI .46-.76), for very active, active, and moderately active groups. No interactions were significant. Conclusions: These results indicate that physical activity protects against elevated mortality to the same extent in those with MDD as those without. These results support continued efforts to integrate physical activity into the management of depressive disorders.
Journal of Adolescent Health, 2012
Purpose: Low levels of physical activity (PA) have been shown to be associated with depression in adults. The few studies that focused on adolescents yielded mixed and inconsistent results. Efforts to examine the direction of this relationship have been inconclusive up to now. The aims of this study were therefore to investigate (1) the direction of the inverse association between PA and depressive symptoms over time, and (2) whether these associations are specific to particular clusters of depressive symptoms in adolescents. Methods: Depressive symptoms and PA were assessed in a population sample of adolescents (N ϭ 2,230) who were measured at three waves between age 10 and age 17. Depressive symptoms were measured by the Affective Problems scale of the Youth Self-Report and Child Behavior Checklist, whereas PA was operationalized as the amount of time spent on physical exercise. Structural equation modeling was used to examine bidirectional effects of PA and depressive symptoms over time. Results: We found significant cross-lagged paths from prior PA to later depression as well as from prior depression to later PA (beta values ϭ Ϫ.039 to Ϫ.047). After subdividing depression into affective and somatic symptoms, the affective symptoms were reciprocally related to PA, whereas the paths between somatic symptoms and PA did not reach statistical significance. Conclusions: An inverse bidirectional association between PA and general depressive symptoms was observed. This association was restricted to affective symptoms.
The association of physical activity and depression in Type 2 diabetes
Diabetic Medicine, 2008
Objectives: Osteoarthritis (OA) patients are at increased risk of depression, and low levels of physical activity (PA) are a potential warning sign of depression. PA can be estimated by patient reported outcomes (PROs) or measured with accelerometers (ACCs). We explored which of these two best captures depression in patients with, or at risk of, OA. Methods: 48-months data from the Osteoarthritis Initiative were cross-sectionally analysed. The dichotomized Centre for Epidemiological Studies Depression Scale score was used as outcome (depression y/n). The Physical Activity Scale for the Elderly (PASE) was selected as PRO. ACC-data comprised average minutes of daily moderate to vigorous activity. Two multivariable models (PRO-model/ACC-model) were compared directly and indirectly using areas under the curve (AUC) for the predicted probability of depression, penalized model selection criteria (PMSC) and log-likelihood ratio tests. Results: AUCs from the ACC (0.71 [95% CI 0.67; 0.75]) and PRO model (0.72 [95% CI 0.68; 0.76]) were not significantly different (p = 0.28). Differences in PMSC were small (<10). The log-likelihood ratio test for the comparison of the ACC (ll À505.22) with the base model (ll À505.98) was not significant (LR chi 2 = 1.52; p = 0.22), but the PRO model (ll À501.55) had a better fit than the base model (LR chi 2 = 8.87; p < 0.01). Conclusions: PRO and ACC data perform similarly in capturing depression. Indirect comparison even pleads for PROs. Costs of accelerometers and the additional burden for patients are in support of the PASE as an appropriate alternative to screen for depression in OA patients.